摘要
目的:比较全胸膜照射螺旋断层放射治疗(HT)计划与调强放射治疗(IMRT)计划靶区和危及器官(OAR)的剂量学参数,观察近期疗效及安全性,为HT技术在全胸膜放射治疗的临床应用提供参考。方法:采用随机数表法选取医院收治的8例行HT治疗全胸膜照射患者,分别进行HT和IMRT两种计划设计,并定义为HT组和IMRT组,比较两组剂量学参数的适形指数(CI)、均匀性指数(HI)和OAR的受量,观察两组患者的急性不良反应和近期疗效。结果:计划靶区中HT组PTV的CI和HI分别为0.829±0.027和0.069±0.012,优于IMRT组的0.730±0.014和0.219±0.018,差异有统计学意义(t=2.124,t=4.327;P<0.001);HT组D_(98)、D_(95)均高于IMRT组,D_(1)及D_(2)均低于IMRT组,差异有统计学意义(t=3.467,t=4.432;t=-4.664,t=-2.423;P<0.001);D_(mean)略高于IMRT组。在OAR中HT组全肺除V_(5)无差异外,V_(10)、V_(20)和D_(mean)均优于IMRT组,差异有统计学意义(t=5.883,t=3.060,t=2.799;P<0.001);HT组心脏V_(30)、V_(40)、D_(50)均低于IMRT组,差异有统计学意义(t=3.468,t=5.391,t=5.676;P<0.001);HT组肝脏V_(5)、V_(10)、D_(mean)显著低于IMRT组,差异有统计学意义(t=4.147,t=2.243,t=5.293;P<0.001);HT组脊髓D_(max)低于IMRT组,差异有统计学意义(t=5.547,P<0.001)。所有患者治疗后临床症状消失或缓解,未出现严重的急性不良反应。结论:HT在全胸膜放射治疗中,可以在保护周围正常组织的基础上有较好的剂量分布,以及较好的适形度和均匀性,近期疗效评估效果显著。采用HT治疗时,在OAR能控制的情况下,肿瘤区可给予更高剂量的照射,结合序贯辅助化疗,不良反应发生率相对较低,具有较好的临床应用价值。
Objective:To compare the differences of dosimetry parameters of target areas and organs-at-risk(OAR)between the helical tomotherapy(HT)and the intensity-modulated radiotherapy(IMRT)in totally pleural irradiation,and to observe the short-term curative effect and safety so as to provide reference for the clinical application of HT technique in radiotherapy for total pleura.Methods:Eight patients who admitted to hospital and underwent totally pleural irradiation of HT treatment were selected by adopting random number table.And two kinds of plan designs(HT and IMRT)were performed on them and they were defined as HT group and IMRT group,respectively.The conformity index(CI),homogeneity index(HI)and OARs radiation dose of dosimetry parameters of the two groups were compared.The acute adverse reaction and short-term curative effect of two groups were further observed.Results:The CI and HI of HT group were(0.829±0.027)and(0.069±0.012)in planning target volume(PTV),which significantly better than those(0.730±0.014 vs 0.219±0.018)of IMRT group(t=2.124,t=4.327,P<0.001).D_(98) and D_(95) of HT group were significantly higher than those of IMRT group,while D_(1) and D_(2) of HT group were significantly lower than those of IMRT group(t=3.467,t=4.432,t=-4.664,t=-2.423,P<0.001).And former D_(mean) was slightly higher than that of IMRT group.In OAR,the V_(10),V_(20) and D_(mean) of total lung of HT group were significantly better than those of IMRT group beside of V_(5)(t=5.883,t=3.060,t=2.799,P<0.001).The V_(30),V_(40) and D_(50) of the heart of HT group were significant lower than those of IMRT group(t=3.468,t=5.391,t=5.676,P<0.001).The V_(5),V_(10) and D_(mean) of the liver of HT group were significantly lower than those of IMRT group(t=4.147,t=2.243,t=5.293,P<0.001).D_(max) of spinal cord of HT group was also significantly lower than that of IMRT group(t=5.547,P<0.001).After treatment,the clinical symptoms of all patients disappeared or were relieved,and there was not seriously acute adverse reaction.Conclusion:In total p
作者
刘娟
李双双
高山宝
侯震
朱丽晶
王孔成
闫婧
LIU Juan;LI Shuang-shuang;GAOShan-bao(Cancer Centre,Drum Tower Hospital,The Affiliated Hospital of Nanjing University Medical School,Nanjing 210000,China;不详)
出处
《中国医学装备》
2021年第7期13-17,共5页
China Medical Equipment
